Liver laceration and pancreatic trauma

Case contributed by Dr Jeremy Jones

Presentation

Restrained passenger in RTC. Abdominal bruising and tenderness. Haemodynamically stable.

Patient Data

Age: 7 years
Gender: Female

No pneumothorax. No effusion. No rib fracture. Normal mediastinum. Normal lung parenchyma - no focal consolidation.

Liver laceration extends throughout segments II, III and IV. No active extravasation. Associated hemoperitoneum.

Low density region in the proximal body of pancreas concerning for pancreatic injury. 

Right lobe, kidneys and spleen are normal.

Case Discussion

Liver laceration and hemoperitoneum is not challenging to detect. Review areas in children include the mesenteric root, the duodenum (looking for duodenal hematoma) and the pancreas. Pancreatic injury may be subtle.

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